Shoulder Hemiarthroplasty In Patients With Juvenile Idiopathic Arthritis
Below is a MRR and PLR article in category Health Fitness -> subcategory Other.
Shoulder Hemiarthroplasty in Patients with Juvenile Idiopathic Arthritis
Overview
Performing shoulder replacements in patients with Juvenile Idiopathic Arthritis (JIA) is rare, and no comprehensive studies have been published until now. We report on nine glenohumeral hemiarthroplasties conducted on eight patients with either systemic or polyarticular JIA. The average follow-up period was 73 months, ranging from 59 to 89 months, and the mean age at the time of surgery was 32 years, occurring an average of 27 years after diagnosis.
Study Findings
The surgeries provided significant pain relief and improved shoulder functionality, although there was some decline over time due to disease progression in this severely affected group. Notably, none of the patients required revision surgery, and no radiological signs of implant loosening or bone degradation were observed. We address the unique anatomical challenges in these cases, such as limited space for prosthetics and the need for custom implants due to bone deformity and small size.
Disease Context
Shoulder arthritis is not typically an early symptom of JIA; hip and knee joints are more commonly affected and treated by arthroplasty. Involvement of the shoulder occurs later in systemic or polyarticular JIA, with a 15% incidence 15 years after disease onset. Prolonged arthritis can lead to underdeveloped humeral and glenoid structures and eventual erosion of bone and cartilage, causing displacement of the humeral head. This dysfunction severely impacts daily activities, such as self-care and mobility aid usage.
Challenges and Outcomes
If the elbows are also affected, upper limb functionality further diminishes. One patient experienced persistent tingling and discomfort in the forearm post-surgery that did not improve with usual treatments. Despite normal nerve-conduction studies and MRI findings indicating a potential cervical spine issue, the patient declined further intervention. No other significant complications were reported.
Conclusion
While this study involves a small group of patients without an untreated control group, it provides valuable insights into shoulder hemiarthroplasty outcomes in JIA patients. The methodology employed was otherwise sound and may guide future surgical approaches in similarly affected individuals.
You can find the original non-AI version of this article here: Shoulder Hemiarthroplasty In Patients With Juvenile Idiopathic Arthritis.
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